Pham Q.D.,Pasteur Institute |
Do N.T.,Vietnam Authority of HIV AIDS Control |
Le Y.N.,Centers for Disease Control and Prevention |
Nguyen T.V.,Pasteur Institute |
And 12 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2015
Objectives: The objective of this study was to determine the prevalence and correlates of pretreatment drug resistance (PDR) to first-line antiretroviral drugs among people initiating therapy for HIV in Vietnam. Methods: Bloodwas collected during November 2009 to October 2010 from people consecutively initiating ART in four purposively selected public outpatient clinics in three Vietnamese cities. At each study site, recruitment lasted for 6-10 months until the target sample size (range 120-130 individuals) had been reached. The viral load was measured in 501 samples; 490 samples (viral load ≥1000 copies/mL) were genotyped using a nucleotide population-based sequencing assay. Self-reported demographic and clinical data were elicited through interviews. We classified drug-resistance-associated mutations (DRMs) according to the 2009 WHO surveillance list. Results: DRMs were identified in 17/490 participants (3.5%; 95% CI 2.2%-5.5%). The prevalence of DRMs was 1.6% (8/490) against NRTIs, 1.6% (8/490) against NNRTIs and 0.8% (4/490) against PIs; three (0.6%) participants were resistant to both NRTIs and NNRTIs. The overall prevalence of PDR to first-line drugswas low[2.7% (13/490); 95% CI 1.6%-4.4%]. The prevalence of PDR to first-line drugs was greater among 198 HIV-infected participants who injected drugs than among 286 participants who reported risks for sexually acquired HIV (4.0% versus 1.4%, P=0.079). Multivariable logistic regression analysis suggested that PDR to first-line drugs was significantly higher among people who injected drugs (OR=3.94; 95% CI 1.13-13.68). Conclusions: With low PDR, first-line ART may be effective in Vietnam and pretreatment genotyping may be unnecessary. Continuing strategies for the prevention and surveillance of antiretroviral resistance are important for maintaining a low prevalence of antiretroviral resistance in Vietnam. The association between resistance and injection drug use warrants further research. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Pham Q.D.,University of New South Wales |
Nguyen T.V.,Pasteur Institute |
Hoang C.Q.,University of Oxford |
Cao V.,Pasteur Institute |
And 6 more authors.
Sexually Transmitted Diseases | Year: 2012
BACKGROUND: The prevalence of HIV and sexually transmitted infections among men who have sex with men (MSM) has increased substantially in Vietnam. This study aimed to estimate the prevalence of HIV, syphilis, urethral gonorrhoea, and urethral chlamydia, and determined correlates of HIV infection among MSM in An Giang, Vietnam. METHODS: A group of 381 MSM were recruited in a community-based cross-sectional survey between August and December 2009. Face-to-face interviews were conducted for collecting data on sociodemographics, behaviors, and access to HIV prevention programs. Serological tests for HIV and syphilis and polymerase chain reaction for gonorrhoea/chlamydia were performed. Multivariate regression analyses were used to investigate the correlates of HIV infection. RESULTS: The prevalence of HIV, syphilis, gonorrhoea, chlamydia, and gonorrhoea/chlamydia were 6.3%, 1.3%, 1.8%, 3.2%, and 4.7%, respectively. HIV prevalence among 63 injecting MSM was significantly higher than that of 318 noninjectors (20.6% vs. 3.5%, P < 0.001). Approximately 40.4% identified as heterosexual and 42.8% had ever had sex with females. The rate of unprotected anal intercourse with another male in the last month was substantially high (75.3%). Injecting drugs (adjusted prevalence ratio [aPR] = 2.88, 95% confidence interval [CI]: 1.12-7.42), being transgender (aPR = 4.27, 95% CI, 1.17-15.57), and unprotected sex with a female sex worker (aPR = 4.88, 95% CI: 1.91-12.50) were significantly associated with HIV infection. The infection risk increased with age to a peak of 25 years and then decreased. CONCLUSIONS: Although prevalence levels are lower in An Giang, Vietnam than in some other comparable locations, HIV/sexually transmitted infections prevention, and sexual health promotion targeting MSM are highly important in this location. Copyright © 2012 American Sexually Transmitted Diseases Association All rights reserved.
Nguyen T.V.,Pasteur Institute Hochiminh City |
van Khuu N.,Pasteur Institute Hochiminh City |
Nguyen P.D.,Pasteur Institute Hochiminh City |
Tran H.P.,Pasteur Institute Hochiminh City |
And 3 more authors.
AIDS and Behavior | Year: 2016
A total of 2768 MSM participated in a survey in southern Vietnam. Univariate and multivariate logistic regression analyses were performed to determine predictors of HIV infection. The prevalence of HIV among MSM was 2.6 %. HIV infection was more likely in MSM who were older, had a religion, had engaged in anal sex with a foreigner in the past 12 months, previously or currently used recreational drugs, perceived themselves as likely or very likely to be infected with HIV, and/or were syphilis seropositive. MSM who had ever married, were exclusively or frequently receptive, sometimes consumed alcohol before sex, and/or frequently used condoms during anal sex in the past 3 months were less likely to be infected with HIV. Recreational drug use is strongly associated with HIV infection among MSM in southern Vietnam. HIV interventions among MSM should incorporate health promotion, condom promotion, harm reduction, sexually transmitted infection treatment, and address risk behaviors. © 2015 Springer Science+Business Media New York
Ahmed T.,Griffith University |
Long N.T.,Vietnam Authority of HIV AIDS Control |
Huong P.T.T.,Vietnam Authority of HIV AIDS Control |
Stewart D.E.,Griffith University
World Medical and Health Policy | Year: 2014
The HIV epidemic in Vietnam is fueled by injecting drug use. Since HIV emerged, because of a law-enforcement-focused drug policy and response, injecting drug users (IDUs) frequently experience drug detention and compulsory treatment. It has taken more than a decade to shift the focus from punitive to liberal policies. This overview presents a brief discussion on policies, responses, and experiences to identify implications. Related literature including government policies, peer-reviewed articles, and reports has been reviewed. The HIV epidemic in IDUs accelerated rapidly in an environment characterized by a lack in understanding and recognition of significance. There was limited leadership and weak direction to implement a countrywide response. Policies and responses gradually shifted to a harm reduction approach and recognized the need for harmonization, relating common features of drug and HIV. The review identifies that government leadership is crucial for supportive policies and long-term strategies. A multi-sectoral collaboration and continuous resource allocation with national priorities is essential to impact on the epidemic. In this review the context of these issues in policies and responses are highlighted and discussed, which gradually can lead towards the development of a substantial response for the drug use-driven HIV epidemic in Vietnam. © 2014 Wiley Periodicals, Inc.
Ahmed T.,Griffith University |
Long T.N.,Vietnam Authority of HIV AIDS Control |
Huong P.T.,Vietnam Authority of HIV AIDS Control |
Stewart D.E.,Griffith University
BMC Public Health | Year: 2015
Background: Hai Phong, located in northern Vietnam, has become a high HIV prevalence province among Injecting Drug Users (IDUs) since the infection shifted from the southern to the northern region of the country. Previous research indicates high levels of drug and sex related risk behaviour especially among younger IDUs. Our recent qualitative research provides a deeper understanding of HIV risk behaviour and highlights views and experiences of IDUs relating to drug injecting and sharing practices. Methods: Fifteen IDUs participated in semi-structured interviews conducted in September-October, 2012. Eligible participants were selected from those recruited in a larger scale behavioural research project and identified through screening questions. Interviews were conducted by two local interviewers in Vietnamese and were audiotaped. Ethical procedures, including informed consent and participants' understanding of their right to skip and withdraw, were applied. Transcripts were translated and double checked. The data were categorised and coded according to themes. Thematic analysis was conducted and a qualitative data analysis thematic framework was used. Results: Qualitative analysis highlighted situational circumstances associated with HIV risks among IDUs in Hai Phong and revealed three primary themes: (i) places for injecting, (ii) injecting drugs in small groups, and (iii) sharing practices. Our results showed that shared use of jointly purchased drugs and group injecting were widespread among IDUs without adequate recognition of these as HIV risk behaviours. Frequent police raids generated a constant fear of arrest. As a consequence, the majority preferred either rail lines or isolated public places for injection, while some injected in their own or a friend's home. Price, a heroin crisis, and strong group norms encouraged collective preparation and group injecting. Risk practices were enhanced by a number of factors: The difficulty in getting new syringes, quick withdrawal management, punitive attitudes, fear of arrest/ imprisonment, lack of resources, incorrect self-assessment, and risk denial. Some of the IDU participants emphasised self-care attitudes which should be encouraged to minimise HIV transmission risk. Conclusion: The IDUs' experiences in Hai Phong identified through our data broaden our qualitative understanding about the HIV transmission risk among IDUs and emphasize the need to strengthen harm reduction services in Vietnam. © 2015 Ahmed et al.
Nguyen H.,Hanoi Medical University |
Le G.,Hanoi Medical University |
Nguyen S.,Hanoi Medical University |
Tran M.,Hanoi Medical University |
Ha N.,Vietnam Authority of HIV AIDS Control
BMC Public Health | Year: 2012
Abstract. Background. In Vietnam, socially marginalized groups such as ethnic minorities in mountainous areas are often difficult to engage in HIV research and prevention programs. This intervention study aimed to estimate the effect of participatory community communication (PCC) on changing HIV preventive ideation and behavior among ethnic minority youth in a rural district from central Vietnam. Methods. In a cross-sectional survey after the PCC intervention, using a structured questionnaire, 800 ethnic minority youth were approached for face-to-face interviews. Propensity score matching (PSM) technique was then utilized to match these participants into two groups-intervention and control-for estimating the effect of the PCC. Results. HIV preventive knowledge and ideation tended to increase as the level of recall changed accordingly. The campaign had a significant indirect effect on condom use through its effect on ideation or perceptions. When intervention and control group statistically equivalently reached in terms of individual and social characteristics by PSM, proportions of displaying HIV preventive knowledge, ideation and condom use were significantly higher in intervention group than in matched control counterparts, accounting for net differences of 7.4%, 12.7% and 5%, respectively, and can be translated into the number of 210; 361 and 142 ethnic minority youth in the population. Conclusions. The study informs public health implications both theoretically and practically to guide effective HIV control programs for marginalized communities in resources-constrained settings like rural Vietnam and similar contexts of developing countries. © 2012 Nguyen et al; licensee BioMed Central Ltd.